2005 -- H 5590 | |
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LC00143 | |
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STATE OF RHODE ISLAND | |
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IN GENERAL ASSEMBLY | |
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JANUARY SESSION, A.D. 2005 | |
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A N A C T | |
RELATING TO HEALTH -- CANCER TREATMENT FUND | |
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     Introduced By: Representative Joanne M. Giannini | |
     Date Introduced: February 16, 2005 | |
     Referred To: House Finance | |
It is enacted by the General Assembly as follows: | |
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     SECTION 1. Chapter 23-67 of the General Laws entitled "The Rhode Island Research |
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and Treatment Fund for Uninsured and Underinsured Women Stricken With Cancer" is hereby |
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amended by adding thereto the following section: |
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     23-67-4. Payments for cancer treatment drugs. -- (a) The director shall establish and |
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administer a program to pay recipients regardless of gender, for costs of drugs prescribed |
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exclusively for the treatment of cancer when those costs are not otherwise reimbursed. The |
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director shall establish eligibility standards and an application process by rule. |
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     (b) Participation in the program shall be limited to persons whose household income is |
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not greater than two hundred percent (200%) of the federal poverty level as established by the |
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federal office of management and budget. |
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     The program shall be available only to eligible residents who have resided in Rhode |
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Island for at least twelve (12) months. |
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     (c) The director shall pay a maximum amount per cancer patient based on the following: |
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     (1) available moneys; |
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     (2) the terms of any contract between the department of health and human services and |
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the provider; and |
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     (3) the reimbursement rates shall be the same as the Medicaid reimbursement rate for the |
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drug, minus the copayment. |
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     (d) Payment shall be made under the program to or on behalf of a program eligible |
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recipient only for costs not reimbursed or eligible for reimbursement by any other third party or |
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governmental entity (including, without limitation, private or group insurance, Medicaid, |
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Medicare, or the veterans’ administration). The director may, however, waive this requirement in |
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individually considered cases if he or she determines that its enforcement will deny services to a |
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class of cancer patients because of conflicting state or federal laws or regulations. The |
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department of health and human services shall make rules to ensure that all third parties and |
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governmental entities (including, without limitation, private or group insurance, Medicaid, |
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Medicare, or the veterans’ administration) make all required benefit payments. |
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     (e) The director may restrict or categorize reimbursements to meet budgetary limitations. |
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     (f) The director shall maintain a cancer drug formulary that shall include all drugs eligible |
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for reimbursement by the program. The director shall establish an internal review procedure for |
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updating the formulary; the procedure shall allow the addition and deletion of allowable drugs to |
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the formulary. The internal review procedure shall take place at least quarterly during a fiscal |
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year. |
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     (g) Payments made under the program established under this section shall be made from |
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the cancer treatment drug fund. |
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     SECTION 2. There is hereby appropriated, out of any money in the treasury not |
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otherwise appropriated, a sum sufficient to accomplish the purposes of this section. Gifts, grants, |
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and donations shall also be accepted and deposited in a restricted receipt account created for that |
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purpose by the treasurer. Unexpended general treasury funds shall be carried over from year to |
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year. |
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     SECTION 3. This act shall take effect upon passage. |
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LC00143 | |
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EXPLANATION | |
BY THE LEGISLATIVE COUNCIL | |
OF | |
A N A C T | |
RELATING TO HEALTH -- CANCER TREATMENT FUND | |
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     This act would establish a fund to assist uninsured and underinsured persons in paying for |
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cancer treatment drugs. |
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     This act would take effect upon passage. |
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LC00143 | |
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